acinic cell adenocarcinoma
Wednesday 14 June 2006
High-grade transformation of acinic cell adenocarcinoma (19461506)
The median age is 61 years (with range from 43 to 76 y).
High-grade transformation of acinic cell carcinoma (AciCC) (previously referred to as dedifferentiation) is a rare phenomenon characterized by histologic progression of low-grade AciCC to high-grade adenocarcinoma or undifferentiated carcinoma.
The high-grade component is composed of polymorphic cells with a high mitotic rate arranged in glandular and solid growth patterns with comedonecrosis.
The MIB-1 labeling indices are elevated in the high-grade component, as compared with the low grade conventional AciCC.
The high-grade component of AciCC is characterized by strong membrane staining for CK18 and beta-catenin, and nuclear staining for cyclin-D1.
HER-2/neu, androgen receptor, C-kit, and epidermal growth factor receptor are absent from both low-grade and high-grade components.
In contrast, S-100 protein, alpha-1-antitrypsin, and lysozyme are lost only in high-grade foci of transformed AciCC.
Lymph node (LN) metastases are found in 56% of cases. Distant metastases to the lungs, pleura, brain, and peritoneum, and paraaortic, paratracheal, and mediastinal LNs are observed.
66% die from tumor dissemination, with a median overall survival of 4.3 years (range: 1 to 9 y).
The high propensity for LN metastases indicates the need for neck dissection at the time of diagnosis.
mammary acinic cell adenocarcinoma
salivary acinic cell adenocarcinoma
Acinic Cell Carcinoma With High-grade Transformation: A Report of 9 Cases With Immunohistochemical Study and Analysis of TP53 and HER-2/neu Genes. Skálová A, Sima R, Vanecek T, Muller S, Korabecna M, Nemcova J, Elmberger G, Leivo I, Passador-Santos F, Walter J, Rousarova M, Jedlickova K, Curik R, Geierova M, Michal M. Am J Surg Pathol. 2009 May 20. PMID: 19461506